Olanzapine plus Fluoxetine was also ranked the highest for response with Lurasidone ( Latuda ) second, but Olanzapine plus Fluoxetine and Olanzapine had the optimal effect on response and withdrawal from treatment when the two parameters were considered together.

In conclusion, Olanzapine plus Fluoxetine should be first-line treatment. Olanzapine, Quetiapine, Lurasidone, Valproate and selective serotonin re-uptake inhibitors are also recommended.
Tricyclic antidepressants and Lithium are worthy of consideration but Lamotrigine ( high risk of switching, less robust efficacy ) and MAOIs, Ziprasidone, Aripiprazole and Risperidone ( no evidence of efficacy ) should not be used. ( Xagena )